STATEMENT OF DEPENDENCY OF PARENT(S)

ICR 198403-2900-004

OMB: 2900-0089

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC ID
Document
Title
Status
146974 Migrated
ICR Details
2900-0089 198403-2900-004
Historical Active 198103-2900-004
VA
STATEMENT OF DEPENDENCY OF PARENT(S)
Extension without change of a currently approved collection   No
Regular
Approved without change 05/02/1984
Retrieve Notice of Action (NOA) 03/20/1984
  Inventory as of this Action Requested Previously Approved
04/30/1987 04/30/1987 06/30/1984
55,000 0 55,000
27,500 0 27,500
0 0 0

VA FORM 21-509 IS USED TO DETERMINE WHETHER OR NOT A PARENT CAN BE CONSIDERED AS DEPENDENT UPON THE SUPPORT OF THE VETERAN. IT IS USED BOTH IN CLAIMS BY A VETERAN WHO CLIAMS HIS/HER PARENT(S) AS DEPENDENT OR IN DEATH COMPENSATION CLAIMS TO ESTABLISH DEPENDENCY. INCOME, NET WORTH, AND ESPENSE DATA ARE REQUIRED TO DETERMINE IF EXPENSES EXCEED INCOME.

None
None


No

1
IC Title Form No. Form Name
STATEMENT OF DEPENDENCY OF PARENT(S) 21-509

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 55,000 55,000 0 0 0 0
Annual Time Burden (Hours) 27,500 27,500 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
03/20/1984


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